Provider Demographics
NPI:1275584203
Name:HECHANOVA, DEMETRIO (MD)
Entity Type:Individual
Prefix:DR
First Name:DEMETRIO
Middle Name:
Last Name:HECHANOVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3452 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3142
Mailing Address - Country:US
Mailing Address - Phone:626-793-2885
Mailing Address - Fax:626-793-6262
Practice Address - Street 1:315 N 3RD AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1905
Practice Address - Country:US
Practice Address - Phone:626-915-4700
Practice Address - Fax:626-214-7814
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA40661207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A406610Medicaid
CA00A406610Medicaid
CAAQ201YMedicare PIN